[Provider] APS Healthcare-Maine Updates

[Provider Notification]

ATTENTION:            MaineCare Behavioral Health Providers

 

There are some new materials posted on the APS Healthcare-Maine Website.
The APS Healthcare-Maine website is: http://www.qualitycareforme.com/

 

A provider update describing revisions in the Level of Care Criteria is
posted at this link:
http://www.qualitycareforme.com/MaineProvider_Update060608b.htm

The revised Level of Care Criteria, dated 6/6/08 is posted at this link:
http://www.qualitycareforme.com/documents/provider_levelofcarecriteria.p
df

 

Important Change for Children's PNMI Providers:

A provider update describing the Children's CBHS-Approved PNMI Room &
Board Authorization Transition Process is posted at this link:
http://www.qualitycareforme.com/MaineProvider_Update060608a.htm

<http://www.qualitycareforme.com/documents/provider_levelofcarecriteria.
pdf>  

Clarification of the 5 Calendar Day Grace Period and Limit for Request
Submissions to the Maine ASO:

1-         Registration Requests and Prior Authorization Requests are
due to APS on the day that service provision begins.  For all providers
(except for PNMI providers), there is a 5 calendar day Grace Period, so
that the Registration may be submitted up to 5 calendar days after
service begins.  Registration Requests may not be submitted beyond the 5
calendar day Grace Period for a particular service start date.

PLEASE NOTE:  This Grace Period does not apply to PNMI Providers.  PNMI
Providers must submit Registration Requests within 24 hours of Admission
for purposes of the PNMI Bed Tracking System.

 

2-         Providers may submit a Continued Stay Request at any time
during an existing authorized period.

The 5 calendar day Grace Period means that the start date for the
Continued Stay Request must be within 5 calendar days of the date that
the Continued Stay Request is submitted.

            For example: 

            A CI Registration authorization expires July 1.  The
provider may choose to submit the Continued Stay Request a month early,
on June 1.

The start date of the CI authorization must be within 5 calendar days of
when the request is submitted (up to June 6). 

 

Can I Spread Out or "Stagger" Continued Stay Requests so they don't all
Come Due at Once?

Providers may choose to submit Continued Stay Requests before they are
due (as noted above), in order to spread them out (or "stagger" ), and
then reduce the impact of having many due in a short period of time.
Many providers have chosen to align Continued Stay Requests with ISP due
dates, in order to further simplify record keeping.

 

 

This is a one-way communication.  Please do not respond to this message.

 

 

 

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